The catchment area for Roswell Park Comprehensive Cancer Center (Roswell Park) encompasses diverse populations including Native American, African Americans/Blacks (AA), Hispanics, refugees and Appalachian populations within the 8-counties designated as ?Western New York? (WNY). Approximately 60% of the population resides in Erie County where Roswell Park is located. Buffalo is the largest city in the region, second largest in New York State (NYS), and is one of the poorest cities in the US, (ranked 4th in 2016). Compared to NYS and US rates, the eight WNY counties have higher overall cancer incidence and mortality rates. Roswell Park seeks to reduce the burden of cancer on our patients and catchment area. Engaging community partners is crucial for achieving the Roswell Park mission and the Community Outreach and Engagement goal is to assure that all cancer patients and communities in WNY can benefit from the clinical and scientific advances accomplished at Roswell Park. To this end, we propose the following Specific Aims: Aim 1: Evaluate significant cancer burden and related disparities relevant to the WNY catchment area. Objectives include examination of data on risk factors, incidence, mortality and survival that impact the cancer burden. Aim 2: Facilitate strategic research and clinical trial participation across Roswell Park relevant to the cancer burden in WNY. Objectives include catalyzing research relevant to and/or involving the communities of the catchment area and promoting engagement with the population in clinical studies and addressing their priorities. Aim 3: Accelerate the implementation of education and resources in collaboration with WNY communities to reduce the cancer burden and related cancer disparities. Objectives include community and clinical partnerships to increase screening and access to cancer treatment and a portfolio of strategic evidence-based interventions relevant to reducing the cancer burden in WNY. Aim 4: Promote policy recommendations and extend the reach of Roswell Park regionally, nationally and globally. Objectives include enhancing evidence-based programs that impact local, regional, national and global health policy to reduce tobacco use, increasing international cancer collaborations (e.g., Cuba; Nigeria), addressing Native American health concerns; and sharing Roswell Park expertise to address global cancer issues (e.g., Kashmir, India). COE future directions include: 1) Enhanced engagement and dissemination of lung cancer screening and vaccines in rural communities; 2) Improved assessment of the catchment area cancer burden through geocoding of incidence and mortality; 3) Enhanced collaborations with community members to reduce fundamental cancer risk and recurrence factors (e.g., nutrition/obesity, exercise, lifestyle and survivorship); and 4) Coalition building to address WNY cancer burden disparities and policies particularly as they relate to breast and lung cancer incidence and mortality.